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Meniscal Allograft Interposition Combined with Proximal Row Carpectomy.

Murphy M Steiner1, Matthew R Willsey1, Frederick W Werner1

  • 1Department of Orthopedic Surgery, SUNY Upstate Medical University, Syracuse, New York.

Journal of Wrist Surgery
|January 26, 2017
PubMed
Summary

Proximal row carpectomy with lateral meniscal allograft interposition (LMAI) offers a motion-preserving alternative for wrist arthritis when standard procedures are contraindicated. Early results suggest comparable function to proximal row carpectomy alone.

Keywords:
meniscal allograftproximal row carpectomy

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Area of Science:

  • Orthopedic Surgery
  • Hand Surgery
  • Musculoskeletal Research

Background:

  • Proximal row carpectomy (PRC) is not suitable for wrists with pre-existing arthritis in the proximal capitate or radiolunate fossa.
  • Patients with these contraindications often undergo wrist arthrodesis, leading to functional limitations.

Purpose of the Study:

  • To evaluate the efficacy of lateral meniscal allograft interposition (LMAI) combined with PRC in patients with symptomatic wrist arthritis.
  • To compare wrist function after PRC with LMAI to that of PRC alone.
  • To assess the short-term durability of the lateral meniscal allograft.

Main Methods:

  • A retrospective review of nine wrists that underwent PRC with LMAI between 2006 and 2012.
  • Assessment of patient demographics, complications, and graft failure rates.
  • Clinical examinations, Disabilities of the Arm, Shoulder, and Hand (DASH) scores, and radiographic analysis were performed.

Main Results:

  • Four patients met inclusion criteria with an average follow-up of 4.2 years.
  • Average DASH scores were 24 (range 9-33).
  • Radiographic analysis showed a decrease in radiocapitate joint space from 2.8 mm to 1.8 mm, with no progression to arthrodesis.

Conclusions:

  • Early outcomes of PRC with LMAI appear comparable to PRC alone.
  • This combined procedure may serve as a viable short-term, motion-preserving option for patients ineligible for PRC.
  • Lateral meniscal allograft interposition shows promise in managing specific wrist arthritis cases.